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J Crohns Colitis. 2014 Apr;8(4):288-95. doi: 10.1016/j.crohns.2013.09.001. Epub 2013 Sep 24.

National estimates of the burden of inflammatory bowel disease among racial and ethnic groups in the United States.

Author information

1
Mount Sinai Hospital Centre for Inflammatory Bowel Disease, University of Toronto, Toronto, Ontario, Canada; Institute for Health Policy Management and Evaluation, University of Toronto, Canada; Division of Gastroenterology and Hepatology, Johns Hopkins School of Medicine, USA. Electronic address: geoff.nguyen@utoronto.ca.
2
Department of Medicine, Lakeridge Health, Oshawa, Ontario, Canada.

Abstract

BACKGROUND:

The epidemiology of inflammatory bowel disease (IBD) is poorly characterized in minorities in the U.S. We sought to enumerate the burden of IBD among racial and ethnic groups using national-level data.

METHODS:

Data from the National Health Interview Survey was used to calculate prevalence and incidence of IBD among adults (≥ 18 years) in 1999. The Nationwide Inpatient Sample was queried to ascertain rates of IBD-related hospitalizations and the Underlying Cause of Death Database was accessed to quantify IBD-related mortality.

RESULTS:

An estimated 1,810,773 adult Americans were affected by IBD yielding a prevalence of 908/100,000, which was higher in Non-Hispanic Whites (1099/100,000) compared with Non-Hispanic Blacks (324/100,000), Hispanics (383/100,000), and non-Hispanic Other (314/100,000). Relative to Non-Hispanic Whites, the odds ratios for having a diagnosis of IBD associated with being Non-Hispanic Black, Hispanic, and Other Non-Hispanic race after adjusting for age, sex, and geographic region were 0.33 (95% CI: 0.19 - 0.57), 0.45 (95% CI: 0.26 - 0.77), and 0.34 (95% CI: 0.12 - 0.93), respectively. IBD incidence was similarly lower in Non-Hispanic Blacks (24.9/100,000) and Hispanics (9.9/100,000) compared to Non-Hispanic Whites (70.2/100,000). The ratio of IBD hospitalizations to prevalence was disproportionately higher among Non-Hispanic Blacks (7.3%) compared with Non-Hispanic Whites (3.0%) and Hispanics (2.7%). Similarly, the ratio of IBD-related mortality was greater in Non-Hispanic Blacks (0.061%) compared to Non-Hispanic Whites (0.036%) and Hispanics (0.026%).

CONCLUSIONS:

IBD disease burden is lower in ethnic minorities compared to Non-Hispanic Whites. However, IBD-related hospitalizations and deaths seem disproportionately high in Non-Hispanic Blacks.

KEYWORDS:

Crohn's disease; Hospitalization; Inflammatory bowel disease; Prevalence; Race; Ulcerative colitis

PMID:
24074875
DOI:
10.1016/j.crohns.2013.09.001
[Indexed for MEDLINE]
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